PAIN AND QUALITY-OF-LIFE FOLLOWING RADICAL RETROPUBIC PROSTATECTOMY

Purpose: We assess pain and quality of life following radical retropub ic prostatectomy and determine whether intraoperative anesthetic manag ement has any long-term effects on outcomes. Materials and Methods: A total of 110 patients undergoing radical retropubic prostatectomy were randomly assigned to receive epidural and/or general anesthesia. Pati ents responded to a questionnaire mailed 3 and 6 months following surg ery that assessed prostate symptoms, pain related to surgery, quality of life and mood. Results: No long-term effects of anesthesia were obs erved. Of the 103 respondents (94%) at 3 months 49% had some pain rela ted to surgery. Although pain was not related to anesthesic technique, patients who had it at 3 months used significantly more pain medicati on on postoperative day 3. Pain at 3 months was mild, averaging 1.5 on a scale of 0 to 10, and associated with poor perceptions of overall h ealth (p <0.02), and reduced physical (p <0.01) and social (p <0.01) f unctioning. Pain at 3 months was associated with higher levels of preo perative anxiety (p <0.05). At 6 months 36 of 90 patients (35%) had so me pain related to surgery and the impact was similar. Conclusions: Lo ng-term effects of intraoperative anesthesic technique were not appare nt. Mild pain following radical retropubic prostatectomy was common an d associated with reduced quality of life, particularly social functio ning. Affective distress, particularly anxiety, before surgery and use of pain medications following surgery may be predictors of chronic pa in following radical retropubic prostatectomy.